CHORION WITHOUT AMNION OR CYEMA. 63 



essentially the same changes as uterine specimens developing "under faulty 

 implantation or infection." Maceration changes are present in all specimens, 

 but vary extremely in degree. Coagulation necroses are absent, except in small 

 areas, and beginning "infarct" formation was present only in portions showing 

 especially severe infection. In the latter the destruction apparently had been very 

 rapid and hence the degenerative changes differ somewhat from those produced 

 by a low-grade chronic endometritis pre-existent to the implantation. 



In most of the specimens, as noted by Mall, two forms of degeneration of the 

 villi exist side by side, a fibrous and a "mucoid" transformation of the stroma. 

 The former usually affects but few villi, the latter affects many. Sometimes the 

 degenerate stroma, instead of being "mucoid," was finely granular. In some cases 

 many villi show intense so-called granular hyperplasia. Blood-vessels were absent 

 in both the chorionic membrane and the villi of many of the specimens, a fact 

 which is especially significant in connection with the duration of the changes under 

 consideration. In one instance (No. 596) many of the vessels were in the last 

 stages of degeneration; another specimen showed the presence of numerous small 

 abscesses between the epithelium and the stroma of the chorionic membrane. 

 In those specimens in which the cavity of the chorionic vesicles had been infected, 

 the chorionic membrane was not only decidedly thickened as a result of the loosen- 

 ing up of the fibrous tissue, but also was undergoing a very rapid destruction. In 

 these instances it is not uncommon to find the infectious process invading the 

 stroma of the villi from that of the chorionic membrane, but as long as the chorionic 

 epithelium was found intact an extramural infection, no matter how severe, was 

 never noticed to have caused an inflammatory reaction in the villi or in the chori- 

 onic membrane, not even in cases in which the latter was surrounded by a wall of 

 polymorphonuclear leucocytes. 



The content of these amnionless chorionic vesicles was usually a coagulum, 

 which was generally amorphous or finely granular, but rarely also finely webbed 

 or reticulated, reminding one of the "corps reticule" of Velpeau (1855). The 

 only histological elements which this magma contained were small fragments of 

 or cells from the chorionic membrane and clumps of erythroblasts, composed 

 either of individual or of coalescing cells, or the degeneration forms of these or of 

 other embryonic cells. Some foreign materials and remnants of the yolk-sac rarely 

 also were present, and fibrosis of the decidua, which is to be discussed separately, 

 was quite common. 



It was especially interesting that this group also contained specimens illus- 

 trating the process of intrauterine destruction and absorption of early conceptuses. 

 In one specimen (No. 606) measuring 18 by 13 by 6 mm., all the tissues, even 

 including the last or smallest remnant of the nuclei, had been destroyed completely. 

 Not a single cell contour was preserved; not even by coagulum, as is frequently 

 the case in non-degenerate deciduse. Yet in spite of these things, the form and 

 relative proportions of the entire vesicle, with its surrounding villi, were preserved 

 so well that in describing the gross specimen, Mall noted: "In appearance the 



